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1.
Arthroscopy ; 38(1): 7-9, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34972560

RESUMO

Medical providers, rehabilitation specialists, and researchers must incessantly refine and adjust specific protocols, understanding that rehabilitation is the critical ingredient for return to sport in athletes. This month introduces a Special Issue in Arthroscopy, Sports Medicine, and Rehabilitation entitled "Rehabilitation and Return to Sport in Athletes." The articles have been authored by invited experts and rehabilitation specialists deemed thought leaders. The goal of the issue is to provide readers, researchers, and clinicians high-yield and high-impact articles that will optimize return to sport in athletes. For athletes, and non-athletes alike, there lies an essential quartet for recovery: 1) correct diagnosis, 2) restoration of anatomy, 3) biological healing, and 4) functional rehabilitation. Most importantly, a coordinated rehabilitation program must be chosen with appropriate specialization to synchronize the return to play. This Special Issue explores specific rehabilitation paradigms regarding return to sport using evidence-based medicine with support from literature to optimize the functional return of athletes.


Assuntos
Traumatismos em Atletas , Medicina Esportiva , Esportes , Artroscopia , Atletas , Humanos , Volta ao Esporte
2.
Bone Joint J ; 104-B(1): 68-75, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34969286

RESUMO

AIMS: The ideal management of acute syndesmotic injuries in elite athletes is controversial. Among several treatment methods used to stabilize the syndesmosis and facilitate healing of the ligaments, the use of suture tape (InternalBrace) has previously been described. The purpose of this study was to analyze the functional outcome, including American Orthopaedic Foot & Ankle Society (AOFAS) scores, knee-to-wall measurements, and the time to return to play in days, of unstable syndesmotic injuries treated with the use of the InternalBrace in elite athletes. METHODS: Data on a consecutive group of elite athletes who underwent isolated reconstruction of the anterior inferior tibiofibular ligament using the InternalBrace were collected prospectively. Our patient group consisted of 19 elite male athletes with a mean age of 24.5 years (17 to 52). Isolated injuries were seen in 12 patients while associated injuries were found in seven patients (fibular fracture, medial malleolus fracture, anterior talofibular ligament rupture, and posterior malleolus fracture). All patients had a minimum follow-up period of 17 months (mean 27 months (17 to 35)). RESULTS: All patients returned to their pre-injury level of sports activities. One patient developed a delayed union of the medial malleolus. The mean return to play was 62 days (49 to 84) for isolated injuries, while the patients with concomitant injuries returned to play in a mean of 104 days (56 to 196). The AOFAS score returned to 100 postoperatively in all patients. Knee-to-wall measurements were the same as the contralateral side in 18 patients, while one patient lacked 2 cm compared to the contralateral side. CONCLUSION: This study suggests the use of the InternalBrace in the management of unstable syndesmotic injuries offers an alternative method of stabilization, with good short-term results, including early return to sports in elite athletes. Cite this article: Bone Joint J 2022;104-B(1):68-75.


Assuntos
Traumatismos do Tornozelo/cirurgia , Traumatismos em Atletas/cirurgia , Ligamentos Articulares/lesões , Ligamentos Articulares/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Suturas , Adolescente , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Volta ao Esporte
3.
Ital J Pediatr ; 47(1): 221, 2021 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-34742330

RESUMO

BACKGROUND: With the gradual resumption of sports activities after the lock-down period for coronavirus pandemic, a new problem is emerging: Allow all athletes to be able to return to compete after SARS-CoV-2 infection in total safety. Several protocols have been proposed for healed athletes but all of them have been formulated for the adult population. The aim of the present study is to evaluate the adequacy of Italian practical recommendations for return-to-paly, in order to exclude cardiorespiratory complications due to COVID-19 in children and adolescents. METHODS: Between April 2020 and January 2021 the Italian Sports Medical Federation formulated cardiorespiratory protocols to be applied to athletes recovered from SARS-CoV-2 infection. The protocols take into account the severity of the infection. Protocols include lung function tests, cardiopulmonary exercise test, echocardiographic evaluation, blood chemistry tests. RESULTS: From September 2020 to February 2021, 45 children and adolescents (aged from 9 to 18 years; male = 26) with previous SARS-CoV-2 infection were evaluated according to the protocols in force for adult. 55.5% of the subjects (N = 25) reported an asymptomatic infection; 44.5% reported a mild symptomatic infection. Results of lung function test have exceeded the limit of 80% of the theoretical value in all patients. The cardiorespiratory capacity of all patients was within normal limits (average value of maximal oxigen uptake 41 ml/kg/min). No arrhythmic events or reduction in the ejection fraction were highlighted. CONCLUSION: The data obtained showed that, in the pediatric population, mild coronavirus infection does not cause cardiorespiratory complications in the short and medium term. Return to play after Coronavirus infection seems to be safe but it will be necessary to continue with the data analysis in order to modulate and optimize the protocols especially in the pediatric field.


Assuntos
COVID-19/complicações , Volta ao Esporte , Adolescente , Fatores Etários , COVID-19/fisiopatologia , COVID-19/terapia , Aptidão Cardiorrespiratória , Criança , Protocolos Clínicos , Feminino , Humanos , Itália , Masculino , Recuperação de Função Fisiológica , Testes de Função Respiratória , Fatores de Tempo
4.
Sports Med Arthrosc Rev ; 29(4): e65-e70, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34730118

RESUMO

Successful rehabilitation of sports-related orthopedic injuries remains a challenge for both orthopedic surgeons and their patients. Team physicians are tasked with the complex problem of minimizing time away from competition, while simultaneously mitigating the risk of reinjury. Varying levels of expectation and demand between recreational and competitive athletes coupled with the already complex nature of sports-related injuries present a multifactorial challenge for the even the most experienced physicians. In the realm of sports medicine, timing of return to sport has become a controversial yet ubiquitous criterion by which treatment outcomes are measured. While accelerated rehabilitation may be desired in many cases, surgeons must also recognize the identifiable risk factors for potential reinjury. With these principles in mind, we present a summary of the available literature on data pertaining to return to sport, with coverage of injuries commonly seen within an orthopedic sports medicine practice.


Assuntos
Traumatismos em Atletas , Ortopedia , Médicos , Medicina Esportiva , Traumatismos em Atletas/terapia , Humanos , Volta ao Esporte
5.
BMC Musculoskelet Disord ; 22(1): 958, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34789227

RESUMO

BACKGROUND: Despite being a common overuse entity in youth soccer, scientific data on risk factors, rehabilitation and return to play for long-standing pubic-related groin pain is still rare. The current prospective cohort study aims to evaluate potential risk-factors, propose a criteria-based conservative rehabilitation protocol and assess return-to-play outcomes among professional youth soccer players suffering from long-standing pubic-related groin pain. METHODS: Male soccer players with long-standing (> 6 weeks) pubic-related groin pain from a professional soccer club's youth academy were analyzed for possible risk factors such as age, team (U12 - U23), younger/older age group within the team, position and preinjury Functional movement score. All injured players received a conservative, standardized, supervised, criteria-based, 6-level rehabilitation program. Outcome measures included time to return to play, recurrent groin pain in the follow-up period and clinical results at final follow-up two years after their return to play. RESULTS: A total of 14 out of 189 players developed long-standing pubic-related groin pain in the 2017/2018 season (incidence 7.4%). The average age of the players at the time of the injury was 16.1 ± 1.9 years. Risk factor analysis revealed a significant influence of the age group within the team (p = .007). Only players in the younger age group were affected by long-standing pubic-related groin pain, mainly in the first part of the season. Injured players successfully returned to play after an average period of 135.3 ± 83.9 days. Only one player experienced a recurrence of nonspecific symptoms (7.1%) within the follow-up period. The outcome at the 24-month follow-up was excellent for all 14 players. CONCLUSIONS: Long-standing pubic-related groin pain is an overuse entity with a markedly high prevalence in youth soccer players, resulting in a relevant loss of time in training and match play. In particular, the youngest players in each team are at an elevated risk. Applying a criteria-based rehabilitation protocol resulted in an excellent return-to-play rate, with a very low probability of recurrence. TRIAL REGISTRATION: The trial was retrospectively registered under DRKS00016510 in the German Clinical Trials Register on 19.04.2021.


Assuntos
Traumatismos em Atletas , Futebol , Adolescente , Idoso , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/epidemiologia , Virilha/lesões , Humanos , Masculino , Dor , Estudos Prospectivos , Volta ao Esporte , Fatores de Risco
6.
BMJ Case Rep ; 14(11)2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34799386

RESUMO

Hamstring injuries are the most common muscle injuries in elite football. Injuries involving the intramuscular tendon are considered more significant, with longer return to play (RTP) times and an increased risk of reinjury. MRI is the gold standard investigation for muscle injuries, but initial findings cannot accurately determine RTP times. The role of MRI in monitoring muscle and tendon healing is not well described. We present three cases of hamstring injuries with intramuscular tendon involvement, illustrating the changes seen on MRI during progressive tendon healing and describing how we utilised this information to inform safe rehabilitation progression. We conclude that intramuscular hamstring tendon healing can be accurately seen on sequential MRI scans and that this information, when combined with traditional rehabilitation markers in and elite sport environment, can be utilised by clinicians to determine the earliest but safe RTP.


Assuntos
Traumatismos em Atletas , Músculos Isquiossurais , Traumatismos da Perna , Relesões , Traumatismos em Atletas/diagnóstico por imagem , Traumatismos em Atletas/prevenção & controle , Músculos Isquiossurais/diagnóstico por imagem , Músculos Isquiossurais/lesões , Humanos , Traumatismos da Perna/diagnóstico por imagem , Imageamento por Ressonância Magnética , Volta ao Esporte
7.
Pediatr Ann ; 50(11): e461-e464, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34757873

RESUMO

Children represent a small fraction of total cumulative cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The potential health consequences related to infection for children are not inconsequential. For example, some may develop multisystem inflammatory syndrome in children, which is commonly associated with cardiovascular involvement. Nevertheless, the short- and long-term effects of SARS-CoV-2 infection remain unknown. In particular, the impact on physical health and how it affects one's ability to return to physical activity are continuously evolving. As more youth sports organizations are lifting restrictions, the volume of youth athletes will increase and the demand for providing medical clearance will grow. This article aims to provide a review of return to physical activity guidelines for young athletes post-SARS-CoV-2 infection based on expert consensus statements and professional organization recommendations. [Pediatr Ann. 2021;50(11):e461-e464.].


Assuntos
Atletas/psicologia , COVID-19/prevenção & controle , Volta ao Esporte , Esportes Juvenis , Adolescente , COVID-19/complicações , COVID-19/epidemiologia , COVID-19/psicologia , Criança , Humanos , SARS-CoV-2 , Síndrome de Resposta Inflamatória Sistêmica
8.
Pediatr Ann ; 50(11): e470-e473, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34757878

RESUMO

The coronavirus disease 2019 pandemic profoundly impacted athletes and organizations of all ages and calibers. As optimism grows and restrictions lift, the mindset of youth sports shifts to prospection. Using the lessons learned during the cancelled, postponed, or modified 2020-2021 season, stakeholders should envision a different playing field moving forward. The void of youth sports highlighted the many values it brings to athletes physically, mentally, and socially. The regionality of sport during the pandemic highlighted resource and funding disparities among communities. Consideration must be given to the overall health of the student-athlete and how to return to competition and spectatorship safely and responsibly. The pandemic required youth sport to collaborate with public health with the hope of creating a semblance of normalcy in upcoming seasons. [Pediatr Ann. 2021;50(11):e470-e473.].


Assuntos
COVID-19/psicologia , Volta ao Esporte , Esportes Juvenis , Adolescente , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Humanos , Pandemias , SARS-CoV-2 , Esportes
9.
Pediatr Ann ; 50(11): e465-e469, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34757879

RESUMO

The widespread shutdown in response to the coronavirus disease 2019 (COVID-19) pandemic, although varied across state and county levels, has undoubtedly impacted everyone to some degree. Within the pediatric population, the closure of schools and organized youth athletic programs has resulted in a unique situation that has made athletes physically deconditioned and at risk for injury. As sports and competition gradually restart, there are considerable risks to the skeletally immature athlete. The anatomic and physiologic changes that occur to bone and cartilage during growth make the young athlete particularly susceptible to both acute and overuse injuries. In the context of the pandemic, deconditioning, obesity, lack of variety, and the resultant mental health burden pose unique challenges in ensuring that young athletes safely return to the field. This review aims to identify risk factors for sport-related injuries and to outline strategies for minimizing these injuries as pediatric patients return-to-play after COVID-19. [Pediatr Ann. 2021;50(11):e465-e469.].


Assuntos
Atletas/psicologia , Traumatismos em Atletas/prevenção & controle , COVID-19/prevenção & controle , Volta ao Esporte , Esportes Juvenis , Adolescente , COVID-19/epidemiologia , COVID-19/psicologia , Criança , Transtornos Traumáticos Cumulativos , Humanos , SARS-CoV-2
10.
J ISAKOS ; 6(6): 363-366, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34794965

RESUMO

IMPORTANCE: One of the most frequent concerns of the increasing number of patients undergoing shoulder arthroplasty is the possibility to resume sport after surgery. OBJECTIVE: The aim of this systematic review was to determine the rate of return to sport after reverse total shoulder arthroplasty (RSA) and the subjective level of performance. EVIDENCE REVIEW: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to perform this systematic review. A systematic electronic search was performed using the PubMed (MEDLINE), Embase and Cochrane Library databases. All the studies analysing the rates were pooled; data were extracted and statistically analysed. The eligibility criteria were studies with at least 20 adult patients recruited. All studies had to relate return to sports after RSA. FINDINGS: A total of six studies were included for a total of 457 patients. Mean age and average follow-up were, respectively, 74.7 years (range 33-88 years) and 3.6 years (range 1-9.4 years). The mean rate of return to sport ranged from 60% to 93%. The mean time for resuming sports was 5.3 months. The overall rate of return to sport after reverse shoulder arthroplasty was 79%. The mean level of sports at the time of the survey was worsened in 7.9%, improved in 39.6% and had no change in 55.2% of the cases. CONCLUSIONS AND RELEVANCE: Based on the current available data, return to sports after reverse shoulder arthroplasty is possible and highly frequent. The subjective level of practice undergoes no change or improves in most of the cases. More studies and better-designed trials are needed in order to enrich the evidence on specific sports recovery after the procedure. LEVEL OF EVIDENCE: IV.


Assuntos
Artroplastia do Ombro , Articulação do Ombro , Esportes , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroplastia , Artroplastia do Ombro/efeitos adversos , Humanos , Pessoa de Meia-Idade , Volta ao Esporte , Articulação do Ombro/cirurgia
11.
Artigo em Inglês | MEDLINE | ID: mdl-34770203

RESUMO

The impact of the COVID-19 pandemic in sport has been the subject of numerous studies over the past two years. However, knowledge about the direct impact of COVID-19 infection on the performance of athletes is limited, and the importance of studies on this topic is crucial during the current pandemic era. This study aimed to evaluate the changes in the match running performance (MRP) of professional soccer players that occurred as a result of COVID-19 infection after fulfilling all of the prerequisites for a safe return to play (RTP). The participants were 47 professional soccer players from a team which competed in first Croatian division (21.6 years old on average) during the 2020/21 season. The total sample was divided into two subgroups based on the results of a PCR test for COVID-19, where 31 players tested positive (infected) and 16 tested negative. We observed the PCR test results (positive vs. negative PCR), the number of days needed to return to the team, number of days needed to RTP after quarantine and isolation, and MRP (10 variables measured by a global positioning system). The number of days where the infected players were not included in the team ranged from 7 to 51 (Median: 12). Significant pre- to post-COVID differences in MRP for infected players were only found for high-intensity accelerations and high-intensity decelerations (t-test = 2.11 and 2.13, respectively; p < 0.05, moderate effect size differences), with poorer performance in the post-COVID period. Since a decrease of the MRP as a result of COVID-19 infection was only noted in two variables, we can highlight appropriateness of the applied RTP. However, further adaptations and improvements of the RTP are needed with regard to high-intensity activities.


Assuntos
COVID-19 , Futebol , Adulto , Humanos , Pandemias , Volta ao Esporte , SARS-CoV-2 , Adulto Jovem
12.
Phys Ther Sport ; 52: 280-286, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34700261

RESUMO

OBJECTIVE: Regular quadriceps strength assessment is important following anterior cruciate ligament reconstruction (ACLR). The one-leg sit-to-stand (OLSTS) test potentially overcomes the barrier of accessibility to specialised testing equipment. However, feasibility and validity testing of OLSTS is lacking in the ACLR population. This study aims to examine the feasibility, correlates, and predictive validity of OLSTS with self-reported running and jumping difficulty in individuals post-ACLR. DESIGN: Retrospective longitudinal study. METHODS: 20 patients with primary unilateral ACLR were tested at 6-months and 1-year post-ACLR. Feasibility was assessed by the number of patients who had safely performed OLSTS at both timepoints. Cross-sectional gender-adjusted Spearman correlations of OLSTS with quadriceps strength, physical impairments, and psychological variables were measured at 6-months. Predictive validity was assessed via ordinal regression, quantifying the associations of OLSTS with self-reported running and jumping difficulty across time-points. RESULTS: All patients understood the instructions to and were able to self-administer the OLSTS test safely. OLSTS is a valid measure of quadriceps strength (gender-adjusted Spearman's ρ = 0.53, P = 0.02). Knee pain (ρ = 0.44, P = 0.046) and readiness to return-to-sport (ρ = 0.55, P = 0.02) were additional correlates. Greater OLSTS performance was associated with greater odds of better self-reported running and jumping function (interquartile-range ORs, 12.0 [95% CI: 3.6-45] and 18.5 [95% CI: 5-67], respectively). CONCLUSION: OLSTS is a feasible and valid test of quadriceps strength, demonstrating predictive validity with self-reported running and jumping post-ACLR. OLSTS potentially allows independent tracking of ACLR rehabilitation progress at home - an increasingly urgent necessity in the face of a global pandemic.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Lesões do Ligamento Cruzado Anterior/cirurgia , Estudos Transversais , Estudos de Viabilidade , Humanos , Perna (Membro) , Estudos Longitudinais , Força Muscular , Músculo Quadríceps , Estudos Retrospectivos , Volta ao Esporte
13.
Am J Sports Med ; 49(13): 3479-3487, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34623936

RESUMO

BACKGROUND: A new anterior cruciate ligament (ACL) injury after ACL reconstruction is a feared outcome. PURPOSE: To study the risk of new knee injuries in female soccer players 5 to 10 years after primary unilateral ACL reconstruction and to compare players who returned to soccer with (1) players who did not return and (2) knee-healthy soccer players (controls). STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Demographic, soccer-specific, and surgical data were recorded at baseline for 317 female soccer players (mean ± SD age, 20.1 ± 2.7 years) 1.6 ± 0.7 years after ACL reconstruction and for 119 matched controls (mean age, 19.5 ± 2.5 years). Data on new knee injuries and soccer-playing status were collected 5 to 10 years after ACL reconstruction via a questionnaire. RESULTS: Among players with ACL reconstruction, 222 (70%) responded at a mean 6.5 ± 1.0 years after primary ACL reconstruction. We compared 3 cohorts: (1) among 163 players with ACL reconstruction who returned to soccer, 68 (42%) sustained 44 reruptures and 29 contralateral ruptures; (2) among 59 players with ACL reconstruction who did not return to soccer, 11 (19%) sustained 9 reruptures and 2 contralateral ruptures; and (3) among 113 knee-healthy controls, 12 (11%) sustained 13 ACL injuries. Players who returned had a >2-fold higher risk of a new ACL injury than players who did not return (risk ratio, 2.24; 95% CI, 1.27-3.93; P = .005) and a 4-fold higher risk than controls (risk ratio, 3.93; 95% CI, 2.23-6.91; P <.001). A new ACL, meniscal, or cartilage injury was the most frequent new knee injury. Among players who returned to soccer, 68% reported a new knee injury, and they had a 2- to 5-times higher risk of any new knee injury and knee surgery than players who did not return and controls. CONCLUSION: Two-thirds of female soccer players with ACL reconstruction who returned to soccer sustained a new knee injury within 5 to 10 years; 42% had a new ACL injury. Their risk of a new knee injury and knee surgery was 2 to 5 times greater than that for players who did not return and for knee-healthy controls. New injury may have negative consequences for long-term knee health and should be a critical consideration in the decision to return to play.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Traumatismos do Joelho , Futebol , Adolescente , Adulto , Lesões do Ligamento Cruzado Anterior/epidemiologia , Lesões do Ligamento Cruzado Anterior/cirurgia , Estudos de Coortes , Feminino , Seguimentos , Humanos , Traumatismos do Joelho/epidemiologia , Traumatismos do Joelho/etiologia , Traumatismos do Joelho/cirurgia , Volta ao Esporte , Adulto Jovem
14.
Am J Sports Med ; 49(13): 3495-3501, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34623939

RESUMO

BACKGROUND: Psychological readiness to return to sport has emerged as an important factor associated with outcomes after anterior cruciate ligament reconstruction (ACLR). Psychological factors are potentially modifiable during the course of rehabilitation, and improving them may lead to better outcomes. PURPOSE: To determine whether athletes with a positive psychological response after participation in a neuromuscular training and second injury prevention program had better self-reported function and activity outcomes compared with athletes who did not have a meaningful change. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: After ACLR and the completion of formal rehabilitation, 66 level I/II athletes completed the following self-reported measures at enrollment (pretraining): the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale, the International Knee Documentation Committee (IKDC) subjective knee form, and the 5 subscales of the Knee injury and Osteoarthritis Outcome Score (KOOS). Participants completed these measures after 10 sessions of agility, plyometric, and progressive strength training and at 1 and 2 years after ACLR. Participants who displayed an increase in the ACL-RSI score from pretraining to posttraining that exceeded the minimal clinically important difference (≥10 points) were defined as having a positive psychological response (responders) to training, and those who did not were defined as nonresponders. A mixed-model analysis of variance was used to determine if group differences in IKDC and KOOS scores existed over the 4 time points (pretraining, posttraining, and the 1- and 2-year follow-ups). RESULTS: The responders reported better self-reported function compared with the nonresponders, regardless of time, on the IKDC form (P = .001), KOOS-Sport and Recreation (P = .014), KOOS-Pain (P = .007), and KOOS-Symptoms (P = .002) but not on the KOOS-Quality of Life (P = .078). Overall, 77% of responders and 67% of nonresponders returned to their previous level of sport by 1 year after ACLR (P = .358), and 82% of responders and 78% of nonresponders returned to their previous level of sport by 2 years after ACLR (P = .668). CONCLUSION: Ultimately, 59% of the athletes in this study displayed a meaningful improvement in their psychological outlook over the course of the training program. Responders demonstrated persistently better self-reported function at posttraining and at 1 and 2 years after ACLR, but there were no between-group differences in return-to-sport rates.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Lesões do Ligamento Cruzado Anterior/cirurgia , Estudos de Coortes , Humanos , Qualidade de Vida , Volta ao Esporte , Autorrelato
15.
Zhonghua Yi Xue Za Zhi ; 101(37): 2975-2981, 2021 Oct 12.
Artigo em Chinês | MEDLINE | ID: mdl-34638187

RESUMO

Objective: To investigate the outcomes and factors influencing postoperative return-to-sport of patients with chronic ankle instability (CAI) underwent all-inside arthroscopic lateral collateral ligament repair. Methods: Patients with CAI treated at Huashan Hospital of Fudan University from January 2017 to August 2019 were retrospectively recruited. Preoperative and postoperative Tegner and Karlsson scores were evaluated and compared, and a multivariate Cox regression model was applied to explore factors influencing postoperative return to desired sports postoperatively. Results: A total of 81 patients with CAI treated by all-inside arthroscopic lateral collateral ligament repair were assessed, including 44 males and 37 females with a mean age of (32.7±9.9) years. Karlsson scores (M(Q1, Q3)) increased from 55.0 (40.0,65.0) preoperatively to 90.0 (85.0,95.0) postoperatively (P<0.01), while Tegner scores increased from 3.0 (1.0,4.0) preoperatively to 5.0 (4.0,6.0) postoperatively (P<0.01). Sixty patients returned to their desired sports with a median return-to-sport time of 9.0 months. Multivariate Cox regression analysis showed that higher age (HR=0.95, 95%CI: 0.92-0.99, P<0.01) and lower preinjury activity levels (HR=1.43, 95%CI: 1.10-1.85, P<0.01) were independent factors affecting postoperative return-to-sport. The one-year postoperative return-to-sport cutoff scores were 37 years old and a Tegner score of 4, respectively. Conclusions: The all-inside arthroscopic lateral collateral ligament repair procedure can achieve good short-term outcomes for patients with CAI, permitting a high incidence of postoperative return-to-sport. Higher age and lower pre-injury activity levels are independent factors hindering postoperative return-to-sport.


Assuntos
Ligamentos Laterais do Tornozelo , Volta ao Esporte , Adulto , Tornozelo , Articulação do Tornozelo/cirurgia , Feminino , Humanos , Ligamentos Laterais do Tornozelo/cirurgia , Masculino , Estudos Retrospectivos , Adulto Jovem
16.
Am J Sports Med ; 49(13): 3602-3612, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34652224

RESUMO

BACKGROUND: Return to sports (RTS) and patient-reported outcomes (PROs) for high-level athletes after bilateral hip arthroscopy have not been well established. PURPOSE: (1) To report minimum 2-year PROs and RTS rates in high-level athletes who underwent staged bilateral primary hip arthroscopies and (2) to compare clinical results against a propensity-matched control group of high-level athletes who underwent unilateral primary hip arthroscopy. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Data were prospectively collected and retrospectively reviewed for high-level athletes (professional, college, or high school) who underwent staged bilateral hip arthroscopy for femoroacetabular impingement syndrome between September 2009 and October 2018. Inclusion criteria were preoperative and minimum 2-year follow-up for modified Harris Hip Score, Non-arthritic Hip Score, Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and visual analog scale for pain. Exclusion criteria were Tönnis grade >1, hip dysplasia (lateral center-edge angle <18°), and previous ipsilateral hip surgery/conditions. Rates of achieving the minimal clinically important difference (MCID), patient acceptable symptomatic state (PASS), and maximum outcome improvement satisfaction threshold were recorded in addition to RTS. These athletes were then propensity matched in a 1:3 ratio to high-level athletes who underwent unilateral arthroscopy for comparison. Outcomes were compared among the first hip of the study group, the second hip of the study group, and the control group. RESULTS: A total of 74 high-level athletes who underwent bilateral hip arthroscopy met the inclusion criteria, and follow-up was available for 68 (91.9%) at 58.9 ± 24.5 months (mean ± SD). Athletes undergoing bilateral hip arthroscopy returned to sports at a high rate (81.7%), demonstrated significant improvements in all recorded PROs, and achieved the MCID and PASS for the HOS-SSS at rates of 80.9% and 64.7%, respectively. PROs, RTS rate, and rates of achieving the MCID and PASS for the HOS-SSS were similar when the bilateral study group was compared with the unilateral control group (P > .05). CONCLUSION: High-level athletes who undergo staged bilateral primary hip arthroscopy for femoroacetabular impingement syndrome may expect favorable PROs and RTS rates at minimum 2-year follow-up. These results were comparable with those of a propensity-matched control group of high-level athletes who underwent unilateral primary hip arthroscopy.


Assuntos
Artroscopia , Impacto Femoroacetabular , Atletas , Benchmarking , Estudos de Coortes , Grupos Controle , Impacto Femoroacetabular/cirurgia , Seguimentos , Articulação do Quadril/cirurgia , Humanos , Medidas de Resultados Relatados pelo Paciente , Estudos Retrospectivos , Volta ao Esporte , Resultado do Tratamento
17.
Medicina (Kaunas) ; 57(10)2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34684125

RESUMO

Tendinopathy is a complex clinical condition with a rising incidence and prevalence, particularly during sports practice. For the return to play in affected patients, adequate functional and structural recovery of the tendon is the ultimate goal, avoiding the high risk of recurrence. In this perspective, local therapies alongside exercise are showing promising results. Despite evidence suggesting hyaluronic acid (HA) injections as effective in the treatment of tendinopathy, current recommendations about the management of this condition do not include this intervention. HA seems to be an effective therapeutic option for the management of sport-related tendinopathies, but further studies with a larger sample size are needed to confirm available findings. In this narrative review, we analyzed available literature about the rationale of the use of HA in the management of tendon injury and, particularly, in sport-related tendinopathies.


Assuntos
Traumatismos em Atletas , Tendinopatia , Traumatismos em Atletas/tratamento farmacológico , Humanos , Ácido Hialurônico/uso terapêutico , Volta ao Esporte , Tendinopatia/tratamento farmacológico , Tendões
18.
Artigo em Inglês | MEDLINE | ID: mdl-34501857

RESUMO

Anterior cruciate ligament (ACL) rupture is a common injury in young athletes. To restore knee stability and function, patients often undergo ACL reconstruction (ACLR). Historically, there has been a focus in this population on the epidemiology of ACL injury, the technical aspects of ACL reconstruction, and post-operative functional outcomes. Although increasingly recognized as an important aspect in recovery, there remains limited literature examining the psychological aspects of post-operative rehabilitation and return to play following youth ACL reconstruction. Despite technical surgical successes and well-designed rehabilitation programs, many athletes never reach their preinjury athletic performance level and some may never return to their primary sport. This suggests that other factors may influence recovery, and indeed this has been documented in the adult literature. In addition to restoration of functional strength and stability, psychological and social factors play an important role in the recovery and overall outcome of ACL injuries in the pediatric population. Factors such as psychological readiness to return-to-play (RTP), motivation, mood disturbance, locus of control, recovery expectations, fear of reinjury, and self-esteem are correlated to the RTP potential of the young athlete. A better understanding of these concepts may help to maximize young patients' outcomes after ACL reconstruction. The purpose of this article is to perform a narrative review of the current literature addressing psychosocial factors associated with recovery after ACL injury and subsequent reconstruction in young athletes. Our goal is to provide a resource for clinicians treating youth ACL injuries to help identify patients with maladaptive psychological responses after injury and encourage a multidisciplinary approach when treating young athletes with an ACL rupture.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Adolescente , Adulto , Lesões do Ligamento Cruzado Anterior/cirurgia , Atletas , Criança , Humanos , Articulação do Joelho , Volta ao Esporte
19.
Curr Sports Med Rep ; 20(9): 453-461, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34524189

RESUMO

ABSTRACT: Chronic pain in the Achilles tendon is a common problem in both athletes and nonathletes alike. The etiology for the development of Achilles tendinopathy has not been fully elucidated, and there remains multiple theories to explain the pain and dysfunction accompanying this condition. The diagnosis of Achilles tendon problems continues to rely on the clinical history and physical examination. The optimal management of pain, restoration of function, and return-to-sports participation with Achilles tendinopathy are evolving because of the advancement in technologies and research regarding its pathophysiology. This article aims to provide a brief review of the relevant anatomy, differential diagnosis, imaging findings, and an update of the literature on conservative and minimally invasive managements of chronic Achilles tendinopathy.


Assuntos
Tendão do Calcâneo , Tendinopatia , Tendão do Calcâneo/fisiopatologia , Atletas , Diagnóstico por Imagem , Humanos , Volta ao Esporte , Tendinopatia/diagnóstico , Tendinopatia/terapia
20.
Phys Ther Sport ; 52: 147-154, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34492443

RESUMO

OBJECTIVES: To assess the implementation, limited efficacy, and acceptability of the BEAST (better and safer return to sport) tool - a rehabilitation and return-to-sport (RTS) decision tool after anterior cruciate ligament reconstruction (ACLR) in nonprofessional athletes. DESIGN: Prospective cohort. PARTICIPANTS: 43 nonprofessional pivoting sport athletes with ACLR. MAIN OUTCOME: Clinician- and athlete-experienced implementation challenges (implementation), changes in quadriceps power, side hop and triple hop performance from 6 to 8 months after ACLR (limited efficacy), athletes' beliefs about the individual rehabilitation and RTS plans produced by the BEAST tool (acceptability). RESULTS: The BEAST tool was developed and then implemented as planned for 39/43 (91%) athletes. Hop and quadriceps power performance improved significantly, with the largest improvement in involved quadriceps power (standardised response mean 1.4, 95% CI:1.1-1.8). Athletes believed the rehabilitation and RTS plan would facilitate RTS (8.2 [SD: 2.0]) and reduce injury risk (8.3 [SD: 1.2]; 0 = not likely at all, 10 = extremely likely). CONCLUSION: The BEAST tool was implemented with few challenges and adjustments were rarely necessary. Athletes had large improvements in quadriceps power and hop performance on the involved leg. Athletes believed that the individual rehabilitation and RTS plans produced by the tool would facilitate RTS and reduce injury risk.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Lesões do Ligamento Cruzado Anterior/cirurgia , Atletas , Humanos , Força Muscular , Estudos Prospectivos , Volta ao Esporte
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